AAP NCE Boston and Mythbusters

First, Boston. Any faithful readers going to be there? We already have a pretty large, informal crew heading out on Sunday night, 10/12 and I know a lot of you will be at the SOAPM dinner (sponsored by PCC, of course…no one else cares about you :-)). If you’re going to be there, let me know now so I can make sure to say hello - and come eat with us.

Now, for Mythbusters. More than once, but most recently at the coding event in Ohio, I have described how many of our clients report keeping a decent portion of their patients when they drop a plan. I often give an example using a well known and outspoken SOAPM member’s specific data. We wrote a report for our clients, at her well placed insistence, to allow us to count how many families are maintained after dropping a plan, so I know the numbers and don’t have to make something up.

As usual, I got the objection. “Oh, well, that’s so-and-so’s practice, and everyone up there can afford to pay out of pocket, etc.” Baloney. Sure, it might help, but it’s hardly the reason why they do well. Want proof? Check out Lynn Cramer’s recent response over on the SOAPM list to what her office did when they lost a provider:

When we had the sudden unexpected loss of a physician, we turned it into an opportunity to drop the contract with our most hard nosed, lower paying insurance.

If we were going to restrict our patient census, why would we keep contracts that paid less and restrict our inscos who paid us adequately? Our remaining doctors were not willing to work more hours than the extra call hours.

The results? The patients who had been with us awhile still stayed with us, paid at TOS and got a cash discount. Some even found that when the claim paid as out of network they got more money back, than paid out.

The insco, continually hassled by their members who wanted us back on the panel, courted us and finally (9 months later), when we had new provider lined up, we signed back on at a higher fee schedule than ever offered before.

The other inscos were a little jumpy from this, saying, we heard that you dropped xxxxx. They now believe that we are not calling their bluff when we state that we will not accept that payment schedule.

There are so many awesome things with this message, I don’t know where to start. It’s like trying to break down the imagery in a Bob Dylan song or, better (and in my case), a Mars Volta song.

Talk about turning a threat into an opportunity. Most practices turn to locums, etc., when they suddenly lose a doctor - how about trimming the dead branches? Note how through some amazing kind of magic, Lynn is able to keep many of her patients. Why is that? Is her part of PA some affluent suburb of Philly? No. Are they the only pediatricians for 100 miles? No. Are they some 25-doc powerhouse? No. Her secret - she does her homework, makes educated guessed, and plows ahead without fear. Lynn, would you add any? There are at least 3 mini-stories in here that I must have told 100x in various seminars, etc. Heck, I mentioned the bit about the insurance companies coming back 6 to 12 months later in the teleconference I did for Physicians’ Alliance last week…but not for Lynn, just other practices who have gone down this path. That last paragraph - I love how word gets around.